Abstract
I've often been struck by fact that finding a topic for this column isn't difficult-there's always so much going on in biology. When I was typing September's column, I decided to make this idea theme for this month's article. I decided to write about new research in biology that I would come upon in one week. I started very next day, June 13th, without knowing what week would bring. Luckily it was an especially productive week in biology, but, in fact, any week would have provided exciting news. Biology has so many facets and now has so many practical applications as well, that it is constantly providing new and interesting news items. There was a great deal of health-related news during week. Several items dealt with circulatory system. The June 16th issue of The New England Journal of Medicine contained two articles covering opposite ends of spectrum of technological sophistication in cardiology. One was on thrombosis therapy, dissolving heart-attack-causing clots in branches of coronary arteries (Marder & Sherry 1988). Recombinant DNA technology has made it possible to produce enzymes such as streptokinase, urokinase and tissue plasminogen activator which can disrupt fibrin in clots. They are effective if given within a few hours after a heart attack, so blood flow to affected area is restored in time to save heart muscle tissue. While there are still problems with this relatively new therapy, including danger of excessive bleeding, this is first time there has been any treatment available to limit damage of a heart attack. While new advances in medical technology are exciting, Ernest Craige (1988) says that old techniques still have their place in modern medicine. He is referring specifically to auscultation, use of a stethoscope, in diagnosis of heart murmurs. He notes that reports on value of auscultation have practically disappeared from medical literature, as has interest in subject among physicians in practice and in training (p. 1,611). He then cites recent evidence that stethoscope still has a role to play, along with such technologically sophisticated diagnostic techniques as radionuclide scanning, echocardiography and magnetic resonance imaging. Researchers have found that auscultation can provide a tentative diagnosis and indicate which diagnostic technology is most likely to be useful, thus eliminating needless testing. But perhaps even more important, Craige sees physical contact between patient and doctor which occurs during techniques such as auscultation significant in development of a trusting relationship. Conveniently enough, I was covering heart in a health course during week that these two articles came out, so I was able to mention them and show students how old and new blend in medical practice. I also covered other aspects of heart disease, for example, relationship between hypertension and atherosclerosis. I must admit that my presentation on blood pressure was rather one-sided; I spent much more time on high blood pressure than on low. Then on Sunday, June 19th, at end of my week, The New York Times Magazine carried an article on OH Syndrome or orthostatic hypotension, that is low blood pressure brought on by change of posture, such as standing up. Bruce Dobkin (1988) notes that the peril of high blood pressure present in 30 percent of adult Americans is widely recognized, but in some cases low pressure may pose an even more insidious threat of serious illness (p. 50). He contends that blood pressure is usually measured only when patient is sitting, while OH Syndrome would only be apparent on standing. The dangers of this condition include dizziness and fainting and, more seriously, threat of heart attack or stroke because syndrome is more common in people with atherosclerosis. Dobkin thinks that low blood flow caused by low pressure can exacerbate effects of blood clots involved in heart attacks and strokes. Only further research will prove validity of his contention, but his article is a reminder that functions of body can vary in two ways -toward greater or toward lesser activity-and that abnormality on either side can cause health problems. A number of other health problems that received attention during week point up fact that health issues involve more than medicine; they can also involve legal, political and social issues. One Monday there was an article on an Army plan to ship through mail bacteria and viruses studied for use in biological warfare (Pollack 1988). Announcement of plan caused a furor, though cultures of infectious organisms for medical and research purposes are routinely shipped. No one has been known to have been infected, though a small number of packages leak during shipment. The future of this practice is
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